| NPI | 1225429871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 10258) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00003995) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |