| NPI | 1245647700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00007923) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 13889) |
| 183500000X Pharmacist (Licence: IA 18855) | |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |