| NPI | 1043231244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND 5024) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 17070) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-04-04 |