| NPI | 1154698355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 18744) |
| Additional Taxonomies | 1835N0905X Pharmacist Nuclear (Licence: CO 18744) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2011-11-16 |