| NPI | 1710100235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS0019909) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PS0018913) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |