| NPI | 1205142643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00007413) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS KS1-13889) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |