| NPI | 1124365150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS16059) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.011094) |
| 183500000X Pharmacist (Licence: GA RPH012204) | |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2013-01-10 |