| NPI | 1801179072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.0079727) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3778) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2023-06-25 |