| NPI | 1205826146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13608) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2005011758) |
| Enumeration Date | 2005-10-23 |
| Last Update Date | 2007-07-08 |