| NPI | 1285981795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00007287) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH021534) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |