| NPI | 1245672823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 23276) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202212116) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |