| NPI | 1285943167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S014877) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 17111) |
| 183500000X Pharmacist (Licence: UT 4730956-1701) | |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2010-09-27 |