| NPI | 1144561218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 21130) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps46242) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2013-03-14 |