| NPI | 1528395530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 44855) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS40358) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2013-02-07 |