| NPI | 1639539554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT0008428) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS31997) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |