| NPI | 1427439744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2015024638) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-16985) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-08-21 |