| NPI | 1518034685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 14661) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP043822R) |
| 183500000X Pharmacist (Licence: CT 5216) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |