| NPI | 1144558883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 045104) |
| Additional Taxonomies | 1835N0905X Pharmacist Nuclear (Licence: MO 045104) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |