| NPI | 1942518089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS 010855) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 019311) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-12-15 |