| NPI | 1518403724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 8658054-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 8658054-8911) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |