| NPI | 1376952838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 18167) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 6407) |
| Enumeration Date | 2014-08-09 |
| Last Update Date | 2014-08-09 |