| NPI | 1821443987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 15248) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 15246) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |