| NPI | 1184907552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2000174734) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 10338) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |