| NPI | 1245395326 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 20052) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 11666) |
| 183500000X Pharmacist (Licence: VA 0202007916) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |