| NPI | 1841298502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 31383) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 12939) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2013-03-01 |