| NPI | 1982842589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202010184) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 29722) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-11 |