| NPI | 1376780502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS43185) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302032050) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2010-06-30 |