| NPI | 1992137525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 22899) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 14091) |
| 183500000X Pharmacist (Licence: NY 057311) | |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-08-06 |