| NPI | 1508217175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302024267) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps45028) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-28 |