| NPI | 1699033514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 35453) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH020078) |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2012-07-27 |