| NPI | 1891760377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS22060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 11692) |
| 183500000X Pharmacist (Licence: VA 0202012246) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2007-08-01 |