| NPI | 1720428089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 019833) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 14221) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2013-07-01 |