| NPI | 1811350978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 122565) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 18407-40) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-09-27 |