| NPI | 1861834848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 12600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22277) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2022-06-22 |