| NPI | 1871928937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 13272) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 2332) |
| 183500000X Pharmacist (Licence: AK 1768) | |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2013-09-09 |