| NPI | 1447685706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 3619TL) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 044929) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |