| NPI | 1326325226 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS47586)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202213737)  | 
| 183500000X Pharmacist (Licence: GA RPH028396)  | |
| 183500000X Pharmacist (Licence: AR PD12934)  | |
| 183500000X Pharmacist (Licence: MI 5302043851)  | |
| Enumeration Date | 2011-11-07 | 
| Last Update Date | 2015-10-01 |