| NPI | 1891813853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 5882) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 50478) |
| 183500000X Pharmacist (Licence: NV 14691) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |