| NPI | 1013258516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 18315) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 6714254-1701) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2015-10-31 |