| NPI | 1194095463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS21405) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202007211) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |