| NPI | 1982036398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 6824) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS30415) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |