| NPI | 1184845778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS50128) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000027002) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-04-29 |