| NPI | 1811120348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 016449) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0010474) |
| 183500000X Pharmacist (Licence: WA 00022175) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2009-09-01 |