| NPI | 1679803779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS50190) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ s013608) |
| 183500000X Pharmacist (Licence: PR 2518) | |
| 183500000X Pharmacist (Licence: NY 33699) | |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2015-03-07 |