| NPI | 1265840433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 14932) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP044190T) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |