| NPI | 1407262553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S017669) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 65019) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |