| NPI | 1902035538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17617) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 63439) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2010-07-09 |