| NPI | 1659796506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC SC12264) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP7856) |
| Enumeration Date | 2014-03-02 |
| Last Update Date | 2014-03-02 |