| NPI | 1720363237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS34150) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-14919) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2011-10-15 |