| NPI | 1033212402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000028945) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 13520) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2011-06-06 |