| NPI | 1669785697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011021859) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 015036) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2011-08-10 |