| NPI | 1235330028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 6368) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 16206-040) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-02-20 |