| NPI | 1316180086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 11615) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP035084L) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2009-04-10 |