| NPI | 1811339229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.01196655) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0119665) |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2018-04-25 |