| NPI | 1447607320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 25889) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps51084) |
| 183500000X Pharmacist (Licence: VA 0202211498) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |