| NPI | 1023383643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011024504) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15441) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2016-07-07 |