| NPI | 1619116233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302038482) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18638) |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-02-05 |