| NPI | 1336419613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS47343) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302022213) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |