| NPI | 1700066511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2008027651) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 14075) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2010-02-26 |