| NPI | 1396812640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-14607) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 10947) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2009-12-11 |