| NPI | 1346484987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 16119) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA 45464) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |