| NPI | 1629264643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 14186) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118215) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |