| NPI | 1730208372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 116710) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202009270) |
| 183500000X Pharmacist (Licence: WI 13071-040) | |
| 183500000X Pharmacist (Licence: ND 4002) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |