| NPI | 1043622608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 57641) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 2519) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |