| NPI | 1063543841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 12679) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 13273-40) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2014-01-17 |