| NPI | 1881907293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 13991) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 20501) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2013-06-25 |