| NPI | 1326458118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0008020) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP447123) |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2014-05-06 |