| NPI | 1689965782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 007418) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 10582) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2011-04-22 |