| NPI | 1669637278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 64701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp439531) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2020-11-18 |