| NPI | 1629310255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 1087940) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 120734) |
| 183500000X Pharmacist (Licence: IL 051.034750) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2016-01-08 |