| NPI | 1467676502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 28880) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 21652) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |