| NPI | 1598092017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 42225) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps37266) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |