| NPI | 1033543335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS47589) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH028059) |
| 183500000X Pharmacist (Licence: MS E-11930) | |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2014-09-10 |