| NPI | 1073631750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 24436) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 114618-3) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |