| NPI | 1366826380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 19315) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122396) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2016-12-20 |