| NPI | 1184716557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS009723) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH008440) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-30 |