| NPI | 1871586461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH021976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01867700) |
| 183500000X Pharmacist (Licence: VA 0202010161) | |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2007-07-08 |