| NPI | 1124492244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ s014460) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 13070) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |