| NPI | 1336562438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 116604-0) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA G-15815) |
| 183500000X Pharmacist (Licence: WI 17351-40) | |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-01-24 |