| NPI | 1649690587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 15787) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS e-06784) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |