| NPI | 1093935124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3103) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH23852) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2011-07-08 |