| NPI | 1073983615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 12187) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44544) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |