| NPI | 1497996490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 11863) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-14742) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2009-05-11 |