| NPI | 1629368626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 18800) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000613) |
| 183500000X Pharmacist (Licence: DE A1-000383) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |