| NPI | 1265815716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP449330) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI009623) |
| 183500000X Pharmacist (Licence: MO 2012014982) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |