| NPI | 1083615769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12713) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 041611) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2007-07-08 |