| NPI | 1538407515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447451) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202207948) |
| 183500000X Pharmacist (Licence: MD 19302) | |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |