| NPI | 1023222940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT CT10717) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 22851) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2011-12-13 |