| NPI | 1760756787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0011316) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 838) |
| 183500000X Pharmacist (Licence: AZ S006354) | |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |