| NPI | 1679705149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S011923) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 117430) |
| 183500000X Pharmacist (Licence: OR RPH-0015158) | |
| 183500000X Pharmacist (Licence: WA PH60551188) | |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2021-02-02 |