| NPI | 1467575308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R1752) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 23792) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2007-07-08 |