| NPI | 1821320482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 22936) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3004) |
| 183500000X Pharmacist (Licence: RI 3756) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2010-02-08 |