| NPI | 1760718308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 48018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS45050) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-11-14 |