| NPI | 1407088628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 48351) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007335) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2021-08-24 |