| NPI | 1932478179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2005018145) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 443600) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |