| NPI | 1760533343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 44097) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 015237) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |