| NPI | 1194126136 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 10474) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S006505) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |