| NPI | 1861705063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302022396) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 1478) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2010-07-16 |