| NPI | 1851604094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VI 00006470) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP031157L) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2010-07-16 |