| NPI | 1407265796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 17689) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH027814) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |