| NPI | 1831498435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0004810) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA rph018640) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2019-02-07 |