| NPI | 1992005987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52217) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP043227L) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2014-01-22 |