| NPI | 1013269778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302039457) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 016647) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2013-11-21 |