| NPI | 1245456359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID p5903) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p5994) |
| 183500000X Pharmacist (Licence: ID p5117) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-09-02 |