| NPI | 1669897559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS48600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 043425) |
| 183500000X Pharmacist (Licence: KS 1-11810) | |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2014-02-28 |