| NPI | 1215308333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302041437) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 51568) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |