| NPI | 1376861666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp037085r) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV rp0004745) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |