| NPI | 1568700672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 8045) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026287) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |