| NPI | 1588934715 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS40507) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 20109) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |