| NPI | 1235449711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5301024664) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS25735) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |