| NPI | 1417298712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 9049) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 2012) |
| 183500000X Pharmacist (Licence: VI 273) | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |