| NPI | 1992085492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS0016410) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 06814) |
| Enumeration Date | 2011-08-28 |
| Last Update Date | 2011-08-28 |