| NPI | 1336416817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 040267) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |