| NPI | 1588979769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00007228) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP023685L) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |