| NPI | 1376871145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 43012) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 32963) |
| 183500000X Pharmacist (Licence: NV 07828) | |
| Enumeration Date | 2009-12-06 |
| Last Update Date | 2009-12-06 |