| NPI | 1023340361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 9292) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 22606) |
| 183500000X Pharmacist (Licence: AZ 3736) | |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2010-02-11 |