| NPI | 1174851232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.019618) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 43189) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2023-01-06 |