| NPI | 1093016719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 11419) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S012370) |
| 183500000X Pharmacist (Licence: KS 1-08372) | |
| 183500000X Pharmacist (Licence: MO 027131) | |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |