| NPI | 1659661106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH26079) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS38699) |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2011-04-17 |