| NPI | 1194928473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 15695) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 114593) |
| 183500000X Pharmacist (Licence: AK 715) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2007-07-08 |