| NPI | 1619397668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 9997) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 9415) |
| 183500000X Pharmacist (Licence: FL PS22881) | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |