| NPI | 1700973534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000032939) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202207106) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-12-03 |