| NPI | 1306187372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID 44212) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 51023) |
| 183500000X Pharmacist (Licence: OR RPH-0012414-P) | |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-03-15 |