| NPI | 1871929166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 14087) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302040306) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |