| NPI | 1760729073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 011172) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 18792) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |