| NPI | 1306168521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 10216) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WY 2193) |
| 183500000X Pharmacist (Licence: MO 45297) | |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |