| NPI | 1427180959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 011638) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202009827) |
| 183500000X Pharmacist (Licence: NC 15257) | |
| 183500000X Pharmacist (Licence: TX 33550) | |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2014-08-15 |