| NPI | 1528444197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0011562) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p4856) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2015-08-06 |