| NPI | 1558580811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R1010) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI 2359) |
| 183500000X Pharmacist (Licence: MA 19467) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |