| NPI | 1598048928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36187) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 046509-1) |
| 183500000X Pharmacist (Licence: TN 12291) | |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |