| NPI | 1932547502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 11742-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302027781) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |