| NPI | 1831683507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60868380) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 41566) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2019-03-15 |