| NPI | 1427383801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 19515) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH233335) |
| 183500000X Pharmacist (Licence: FL PS42958) | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2011-04-07 |