| NPI | 1366455255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 7474) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP027071L) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |