| NPI | 1629324173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S020320) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 026562) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2014-02-06 |