| NPI | 1558756478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 11218) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS36525) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |