| NPI | 1508069675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 14408) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP438444) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2007-07-08 |