| NPI | 1629140272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13239) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 045247) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-08 |