| NPI | 1316263973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR pd09142) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000033412) |
| 183500000X Pharmacist (Licence: MO 2007025915) | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2010-04-07 |