| NPI | 1497061733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 16051) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007008) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2012-11-23 |