| NPI | 1215980578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 20806) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 45923) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-10-26 |