| NPI | 1184914376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 15926) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-010341) |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2011-04-09 |