| NPI | 1760773402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp441587) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20078) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |