| NPI | 1033274915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 14059) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 12338) |
| 183500000X Pharmacist (Licence: WI 7776) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-07-08 |