| NPI | 1891928222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0004185) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202007074) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |