| NPI | 1528292307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 004676) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS42164) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2010-05-14 |