| NPI | 1669463287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RPH00006877) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 13314) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |