| NPI | 1346594348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14740-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302034375) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |