| NPI | 1093091050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 114336) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 13231-040) |
| Enumeration Date | 2011-10-22 |
| Last Update Date | 2011-10-22 |