| NPI | 1740529171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 8172) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202009540) |
| 183500000X Pharmacist (Licence: MD 19515) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |