| NPI | 1699064311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP033503L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202007254) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |