| NPI | 1306056247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 114817) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 114817-8) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-11 |