| NPI | 1023394038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC SC10919) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 17085) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |