| NPI | 1902022668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 16658) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 018945) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |