| NPI | 1174852776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 11439) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 013550) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2009-12-10 |