| NPI | 1891177234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 36078) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 028810) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2016-11-14 |