| NPI | 1497910665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 12970) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 12992) |
| 183500000X Pharmacist (Licence: IA 19554) | |
| Enumeration Date | 2008-07-26 |
| Last Update Date | 2008-07-30 |