| NPI | 1437574324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 54421) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS37589) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2018-02-15 |