| NPI | 1386965309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 14198) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 16823) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2010-06-14 |