| NPI | 1538467220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 11496) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 18955) |
| 183500000X Pharmacist (Licence: GA 025231) | |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2011-03-04 |