| NPI | 1770810772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 45667) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2004032890) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |