| NPI | 1396732699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 20168) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 26488) |
| Enumeration Date | 2005-10-01 |
| Last Update Date | 2017-09-06 |