| NPI | 1821378340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps44854) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 014048) |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-08-29 |