| NPI | 1114194735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302023473) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 09458) |
| 183500000X Pharmacist (Licence: GA 019841) | |
| 183500000X Pharmacist (Licence: MI 532023473) | |
| 183500000X Pharmacist (Licence: MN 113415) | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2017-02-27 |