| NPI | 1366463242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 11691-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 113912-9) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-07-08 |