| NPI | 1700269644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ SO13805) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 2686) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |