| NPI | 1043525090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 16680) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP443675) |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2011-12-15 |