| NPI | 1558371252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 20658) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD09074) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2017-01-04 |