| NPI | 1497820005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 5857) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00003701) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |