| NPI | 1487755252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 15784) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 10257) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-11-01 |