| NPI | 1497836233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 117616-6) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 12446) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |