| NPI | 1972807998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019109) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302033566) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2013-07-23 |