| NPI | 1871927319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0013792) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S019953) |
| Enumeration Date | 2013-09-01 |
| Last Update Date | 2015-09-23 |