| NPI | 1558466490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 13482) |
| 183500000X Pharmacist (Licence: WI 14269) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-03-20 |