| NPI | 1649673658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP038150L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS46487) |
| Enumeration Date | 2014-10-04 |
| Last Update Date | 2014-10-04 |