| NPI | 1073836037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0010126) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0003788) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2010-03-04 |