| NPI | 1710184361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 19018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 18130) |
| 183500000X Pharmacist (Licence: GA RPH023631) | |
| 183500000X Pharmacist (Licence: VA 0202211307) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2022-10-23 |