| NPI | 1003062837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 17859) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 09990) |
| 183500000X Pharmacist (Licence: TN 24545) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2008-08-12 |