| NPI | 1598000846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 19468) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 6859) |
| 183500000X Pharmacist (Licence: ND 5427) | |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |