| NPI | 1881988343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 12159) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 19815) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |