| NPI | 1558710772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 021254) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 08847) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |