| NPI | 1821367186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 47364) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 26384) |
| 183500000X Pharmacist (Licence: IL 051034836) | |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |