| NPI | 1467443556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 9429) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI R-7938) |
| Enumeration Date | 2005-10-29 |
| Last Update Date | 2007-07-08 |