| NPI | 1639416464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 24328) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 18144) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |