| NPI | 1386873065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 119626) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 339952) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |