| NPI | 1528388618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17057) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ s015870) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2010-06-11 |