| NPI | 1346630258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK R15089) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 37189) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |