| NPI | 1336427426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0007490) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202210154) |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2011-07-24 |