| NPI | 1740565076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 21998) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP446115) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2021-05-06 |