| NPI | 1982088985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 4046) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0115199) |
| 183500000X Pharmacist (Licence: NC 26591) | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2019-10-07 |