| NPI | 1487883336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP438324) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 16026) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2018-03-17 |