| NPI | 1043428477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 12048) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202012528) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |