| NPI | 1851560494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 17613) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 19920) |
| 183500000X Pharmacist (Licence: SC 5972) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |