| NPI | 1336558071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS52036) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP448949) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-16 |