| NPI | 1417297201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS47224) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP038366L) |
| Enumeration Date | 2013-02-15 |
| Last Update Date | 2013-02-15 |