| NPI | 1811228836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 14716) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp447544) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2022-12-19 |