| NPI | 1487997250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 10547-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S017011) |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2013-03-31 |