| NPI | 1750618740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 044771) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15129) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2013-04-16 |