| NPI | 1730319922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 5805551-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp442994) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2009-07-22 |