| NPI | 1487942090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00007193) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S015938) |
| Enumeration Date | 2011-07-16 |
| Last Update Date | 2014-06-15 |