| NPI | 1821498700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S017610) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 9150-40) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-08-28 |