| NPI | 1639539828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 9032) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 22166) |
| 183500000X Pharmacist (Licence: NM RP00004025) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |