| NPI | 1336588391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 18016) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 015027) |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2013-06-22 |