| NPI | 1366712515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202207598) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44769) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |