| NPI | 1356656755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 15285) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps31065) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |