| NPI | 1285819979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0009949) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 13316-40) |
| Enumeration Date | 2008-01-01 |
| Last Update Date | 2008-01-01 |