| NPI | 1093255895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS25678) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PU5649) |
| 183500000X Pharmacist (Licence: CO 13932) | |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |