| NPI | 1326046749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 21221) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 1169) |
| Enumeration Date | 2005-07-10 |
| Last Update Date | 2007-07-08 |