| NPI | 1679841464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 11245-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S010070) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |