| NPI | 1407081615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI 2646) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 16217) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |