| NPI | 1114217957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA pst-011968) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS t-010455) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |