| NPI | 1689030165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302043853) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 22080) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |