| NPI | 1306170303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.018817) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 49312) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2014-08-20 |