| NPI | 1184960155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ s011234) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302025849) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2012-12-19 |