| NPI | 1740565431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P8478) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 043903) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2020-08-18 |