| NPI | 1417160326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-11147) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 040375) |
| 183500000X Pharmacist (Licence: IL 051.028636) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2014-05-22 |