| NPI | 1710292776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 17199) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 23988) |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2010-08-15 |