| NPI | 1780870501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM 00008149) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 17974) |
| 183500000X Pharmacist (Licence: VA 0202204336) | |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2024-10-10 |