| NPI | 1982916623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 62387) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 47304) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2010-07-10 |