| NPI | 1619011905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS31547) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PU6122) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2010-03-29 |