| NPI | 1861668840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302040996) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND 4856) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2020-12-08 |