| NPI | 1033463831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 016268) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026782) |
| 183500000X Pharmacist (Licence: TN 36941) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2013-02-24 |