| NPI | 1598108201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 19390) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH233794) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |