| NPI | 1477892784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps49669) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 66389) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |