| NPI | 1992945273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 119875) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0011746) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2016-03-18 |