| NPI | 1730471269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302020104) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 7747) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2011-05-02 |