| NPI | 1417232877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 15731) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 13384) |
| 183500000X Pharmacist (Licence: IL 051.036531) | |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |