| NPI | 1811295694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 011283) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS47330) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-03-04 |