| NPI | 1407831456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 118183) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 1181834) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2020-08-11 |