| NPI | 1144200940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.0069392) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS37759) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-01-04 |