| NPI | 1962523332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 54927) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PR 3792) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2016-12-05 |