| NPI | 1881625093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 116407-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 11696) |
| 183500000X Pharmacist (Licence: ND 3471) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: ND 3471) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |