| NPI | 1750696324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S018900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP6482) |
| 183500000X Pharmacist (Licence: TX 41822) | |
| Enumeration Date | 2010-08-08 |
| Last Update Date | 2022-08-19 |