| NPI | 1609289933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P6703) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0013530) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |