| NPI | 1992154165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP449120) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH234603) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |