| NPI | 1912239237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM 7028) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 47188) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2010-02-11 |