| NPI | 1043685225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000038278) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 028026) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |