| NPI | 1831476910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 12865) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 41449) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |