| NPI | 1558332528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS40769) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 28860) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-03-29 |