| NPI | 1275729097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202205195) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 20224) |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2019-06-19 |