| NPI | 1770873887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-08199) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 14738) |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2011-04-10 |