| NPI | 1639261985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00005626) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 030068) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2017-01-21 |