| NPI | 1114151859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 0011068) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM 00007436) |
| Enumeration Date | 2009-05-10 |
| Last Update Date | 2013-12-12 |