| NPI | 1275921926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13781) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 17850) |
| 183500000X Pharmacist (Licence: MO 2004034226) | |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |