| NPI | 1518392034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2013024736) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 116177) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2014-07-21 |