| NPI | 1740673722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202208547) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000033442) |
| Enumeration Date | 2015-03-14 |
| Last Update Date | 2015-03-14 |