| NPI | 1013389410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 22415) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100001258) |
| Enumeration Date | 2015-10-24 |
| Last Update Date | 2015-10-24 |