| NPI | 1720363864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202005202) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS46607) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2011-10-20 |