| NPI | 1184159097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 41896) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 11275) |
| 183500000X Pharmacist (Licence: CA 52097) | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2017-04-28 |