| NPI | 1619322989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 11223) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302023986) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |