| NPI | 1891063202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 16520) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-010851) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |