| NPI | 1205123676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-15233) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5854) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |