| NPI | 1750405619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 022936) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 18527) |
| 183500000X Pharmacist (Licence: NH 2328) | |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2007-07-08 |