| NPI | 1740508548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202009885) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV rp0005034) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |