| NPI | 1609135482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP038755L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI004261) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2015-05-24 |