| NPI | 1952890816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 18547-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 123080) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |