| NPI | 1487887956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP042282L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 15044) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |