| NPI | 1225344997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 19938) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 011946) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |