| NPI | 1720452840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS53961) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25513) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |