| NPI | 1659761781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36374) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100001586) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-01-27 |