| NPI | 1275816241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011015224) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 16540) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2011-09-26 |