| NPI | 1851674642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 51652) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 019588) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2023-05-17 |