| NPI | 1134493430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019558) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS57606) |
| Enumeration Date | 2012-03-04 |
| Last Update Date | 2018-04-11 |