| NPI | 1912127853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033-3545) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 14202) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |