| NPI | 1689751406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302034356) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 20248) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |