| NPI | 1902136138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh5442) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 11579) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2022-09-06 |