| NPI | 1639597453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 22970) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS48328) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2014-03-29 |