| NPI | 1659693406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 10569) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 9995) |
| 183500000X Pharmacist (Licence: AL 10936) | |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |