| NPI | 1558681288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH234488) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0011742) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2013-03-11 |