| NPI | 1083938427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 18903) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP443486) |
| 183500000X Pharmacist (Licence: MI 5302037493) | |
| Enumeration Date | 2010-03-14 |
| Last Update Date | 2010-03-14 |