| NPI | 1871800672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH233557) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21403) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2023-05-16 |