| NPI | 1710196688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 3725) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 27234) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-20 |