| NPI | 1730638727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh6019) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122932) |
| Enumeration Date | 2016-10-02 |
| Last Update Date | 2023-10-27 |