| NPI | 1376764738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP441122) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS46023) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2012-02-02 |