| NPI | 1720332687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 7684410-8911) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0013242) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2017-04-10 |