| NPI | 1386707511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP040343L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 09413) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-08 |