| NPI | 1477812428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 51015) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15725-40) |
| 183500000X Pharmacist (Licence: IL 051293964) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |