| NPI | 1851668230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP445655) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 50382) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2019-12-10 |