| NPI | 1194046805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP5558) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS39645) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2014-10-28 |