| NPI | 1225315286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 5566) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 26448) |
| 183500000X Pharmacist (Licence: AZ 5070) | |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |