| NPI | 1245234947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202005291) |
| Additional Taxonomies | 2471B0102X Radiologic Technologist, Bone Densitometry (Licence: VA 0122001317) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-07-08 |