| NPI | 1295109981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2012017551) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15757) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2015-11-18 |