| NPI | 1245237759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM pc00000115) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM rp00006678) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2007-07-08 |