| NPI | 1124314851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 5046) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps41081) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-06-21 |