| NPI | 1184993180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-09663) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 29484) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2011-12-20 |