| NPI | 1952799520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202006756) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH013993) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |