| NPI | 1477868198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S010203) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 9467-40) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2010-08-18 |