| NPI | 1588999551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 16816) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 010743) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2014-10-17 |