| NPI | 1376833517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019862) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302032786) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2014-07-31 |