| NPI | 1780195859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 123527) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND RPh6004) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2019-02-08 |