| NPI | 1952736696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202012797) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 11462) |
| 183500000X Pharmacist (Licence: FL 28924) | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |