| NPI | 1417001249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 9061) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP437499) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2017-04-25 |