| NPI | 1497265185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 0005520) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI 04867) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |