| NPI | 1215173265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT0012277) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44008) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2017-02-25 |