| NPI | 1316246259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-1505) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 18932) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |