| NPI | 1538524772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2012017834) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15307) |
| 183500000X Pharmacist (Licence: FL PS53190) | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2015-12-15 |