| NPI | 1528451242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 2315) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-28356) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |