| NPI | 1285832295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 15317) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC ph3319) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |