| NPI | 1023137254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 17112) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 12468) |
| 183500000X Pharmacist (Licence: IL 0051-286448) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |