| NPI | 1801193321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 11184) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 21708) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2022-12-20 |