| NPI | 1629392733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17871) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5734) |
| 183500000X Pharmacist (Licence: TN 33897) | |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2011-11-21 |