| NPI | 1649592866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 15683) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH22512) |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |