| NPI | 1699049007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 21405) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 14629) |
| 183500000X Pharmacist (Licence: WI 16539) | |
| 183500000X Pharmacist (Licence: IL 051.295033) | |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2017-03-03 |