| NPI | 1568737237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS T08898) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 10185) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2015-06-29 |