| NPI | 1144551243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 12179-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21631) |
| 183500000X Pharmacist (Licence: MI 5302041163) | |
| 183500000X Pharmacist (Licence: IL 051295616) | |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2015-10-29 |