| NPI | 1427463181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 7374100-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP447878) |
| Enumeration Date | 2014-06-21 |
| Last Update Date | 2014-06-21 |