| NPI | 1295158921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 33582) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S008856) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2016-11-17 |