| NPI | 1679723498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302032603) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH022349) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2013-03-29 |