| NPI | 1982926143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 012704) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 17252) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2019-07-11 |