| NPI | 1265877534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 14407) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS50031) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2017-01-20 |