| NPI | 1275883019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 11617) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS0031951) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |