| NPI | 1306282538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 12857) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00005248) |
| 183500000X Pharmacist (Licence: AZ S009975) | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |