| NPI | 1649423625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202207667) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 17783) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |