| NPI | 1336419761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011023417) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15273) |
| Enumeration Date | 2012-01-02 |
| Last Update Date | 2012-01-02 |