| NPI | 1760720460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 16999) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5682) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2024-05-22 |