| NPI | 1396987962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0007045) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202208035) |
| Enumeration Date | 2009-03-29 |
| Last Update Date | 2009-03-29 |