| NPI | 1790982429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2013042829) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD08933) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2019-08-28 |