| NPI | 1578707766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 17011) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps34535) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2009-05-01 |