| NPI | 1013149228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3626) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033-0055647) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |