| NPI | 1275864241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S012817) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 1219) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2014-11-03 |