| NPI | 1316291131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 13285) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202011163) |
| 183500000X Pharmacist (Licence: DE 1-0001883) | |
| 183500000X Pharmacist (Licence: PA RP030075L) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |