| NPI | 1194019356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202011951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS0025706) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |