| NPI | 1427463264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 42126) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 17287) |
| 183500000X Pharmacist (Licence: AZ S016554) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |