| NPI | 1922058460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS30451) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 11018) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |