| NPI | 1861929069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 26518) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202215518) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2017-05-18 |