| NPI | 1184857484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 11544) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 011453) |
| 183500000X Pharmacist (Licence: IL 051-040812) | |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |