| NPI | 1750347506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 6794) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 14718) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2017-01-30 |