| NPI | 1508978016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302022208) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS33298) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |