| NPI | 1427274752 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R1652) | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP-039987-L) | 
| Enumeration Date | 2007-04-17 | 
| Last Update Date | 2007-07-08 |