| NPI | 1932478492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 21701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202208098) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2017-01-16 |