| NPI | 1740609346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 5249088-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P6880) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |