| NPI | 1073922779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00008212) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 7730251-1701) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |