| NPI | 1679113443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD13725) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2016024479) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |