| NPI | 1447658521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 14969) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 10260) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |