| NPI | 1649399171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP437983) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000020980) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |