| NPI | 1003942616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302037695) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 029664) |
| 183500000X Pharmacist (Licence: KS 09813) | |
| 183500000X Pharmacist (Licence: KY 012784) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |