| NPI | 1700160785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM 4360) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 12569) |
| 183500000X Pharmacist (Licence: MO 044650) | |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2013-03-27 |