| NPI | 1265746085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0019832) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 46998) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2017-01-03 |