| NPI | 1225330764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202204599) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000005641) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |