| NPI | 1700153012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RPI001917) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP441671) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |