| NPI | 1689948812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011032869) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD11720) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |