| NPI | 1982156279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 4268) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH238830) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2020-02-12 |