| NPI | 1386974343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S017246) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0022483) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2018-12-11 |