| NPI | 1942582150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60225886) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 3243) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2022-07-21 |