| NPI | 1871036749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R2333) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH232593) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |