| NPI | 1649458035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 016520) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 11899) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2008-02-07 |