| NPI | 1942470778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 23881) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP045606L) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2020-11-24 |