| NPI | 1275839409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202210010) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR pd11500) |
| Enumeration Date | 2011-02-06 |
| Last Update Date | 2011-02-06 |