| NPI | 1073922480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 121727) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 17473-40) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |