| NPI | 1093260325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24043) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2015024644) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2017-04-06 |