| NPI | 1255729984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S021846) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 16477-40) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2016-07-29 |