| NPI | 1407960032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 15124) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 6081) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |