| NPI | 1386939437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16030-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 120355) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |