| NPI | 1801089693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 17705) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: MA 17705) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2007-08-24 |