| NPI | 1114265170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 15384-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI PH3342) |
| 183500000X Pharmacist (Licence: AZ S019168) | |
| Enumeration Date | 2013-01-27 |
| Last Update Date | 2013-01-27 |