| NPI | 1821423336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 014918) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS43222) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-04 |