| NPI | 1376846576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV 7030) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 034037) |
| 183500000X Pharmacist (Licence: FL 46090) | |
| 183500000X Pharmacist (Licence: KY 014618) | |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2010-12-09 |