| NPI | 1912284597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI Ph2849) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 13427) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |