| NPI | 1205886397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 044599) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302410953) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-05-16 |