| NPI | 1275911190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 20137) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS43350) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |