| NPI | 1538570007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S015115) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 111839) |
| Enumeration Date | 2014-05-18 |
| Last Update Date | 2014-05-18 |