| NPI | 1962709311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS53080) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 3135) |
| 183500000X Pharmacist (Licence: SC 13114) | |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2016-01-09 |