| NPI | 1710307525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52980) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 16730) |
| 183500000X Pharmacist (Licence: TN 36044) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |