| NPI | 1871830844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 9906) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH019056) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |