| NPI | 1396850970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 33242) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E5675) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |