| NPI | 1922356401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 15968) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 29015) |
| 183500000X Pharmacist (Licence: AZ 15454) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |