| NPI | 1043477219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 19184) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 20698) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |