| NPI | 1235460932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps45123) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202209241) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2010-01-19 |