| NPI | 1750895660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PR 2857) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: PR 2857) |
| 183700000X Pharmacy Technician (Licence: 2857) | |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |