| NPI | 1043538515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 15655) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp439953) |
| Enumeration Date | 2010-05-09 |
| Last Update Date | 2015-07-13 |