| NPI | 1508294695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 47033) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007548) |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2013-10-28 |