| NPI | 1922550599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6947354-8911) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WY 3822) |
| 183500000X Pharmacist (Licence: UT 6947354-1701) | |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |