| NPI | 1639296379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS37285) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302034040) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |