| NPI | 1538578760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 23517) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 17625) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |