| NPI | 1982850970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 10059) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 18258) |
| 183500000X Pharmacist (Licence: GA 12980) | |
| 183500000X Pharmacist (Licence: MS D6721) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |