| NPI | 1043749609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 17411) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS55328) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-06-07 |