| NPI | 1508273822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP448869) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI008753) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2014-07-18 |