| NPI | 1831144500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 15047) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202004449) |
| 183500000X Pharmacist (Licence: NC 16630) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-02-20 |