| NPI | 1538383500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 7744) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM 6939) |
| 183500000X Pharmacist (Licence: ID P6057) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |