| NPI | 1144694266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S021684) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202213386) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2016-07-15 |