| NPI | 1134443682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 23968) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 14646) |
| 183500000X Pharmacist (Licence: FL PS43033) | |
| 183500000X Pharmacist (Licence: IA 18925) | |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2015-12-22 |