| NPI | 1285919431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 044699) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-11946) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2016-08-30 |