| NPI | 1578904017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS52073) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05362) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2015-04-06 |