| NPI | 1023434974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P6686) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S019688) |
| 183500000X Pharmacist (Licence: ID CS19213) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |