| NPI | 1205125499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446068) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21502) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2016-07-26 |