| NPI | 1245532498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 14008) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 09046) |
| Enumeration Date | 2010-11-20 |
| Last Update Date | 2014-10-13 |