| NPI | 1578874152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13807-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 042252) |
| 183500000X Pharmacist (Licence: OK 9562) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |