| NPI | 1912253311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019211) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3847) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2021-05-24 |