| NPI | 1841337649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 144985-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WY 2299) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |