| NPI | 1336387414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S017807) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 14180-040) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2010-11-24 |