| NPI | 1770949968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP443204) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 011674) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |