| NPI | 1306090402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00006928) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 10538) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |