| NPI | 1578750998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP441589) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0003642) |
| 183500000X Pharmacist (Licence: FL PS42171) | |
| Enumeration Date | 2007-09-30 |
| Last Update Date | 2007-09-30 |