| NPI | 1568663169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S10753) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 35171) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |