| NPI | 1851675052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ s017845) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT ptc.0011090) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |