| NPI | 1467813618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL Ps48129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA Rp030941L) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |