| NPI | 1144411919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS21762) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA MA19499) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-11-19 |