| NPI | 1346260064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 10103-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 15697) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |