| NPI | 1417374497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH26573) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3465) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |