| NPI | 1033409669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS 010895) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 018795) |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2011-04-16 |