| NPI | 1831458710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 112672) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p3929) |
| 183500000X Pharmacist (Licence: ND 3569) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |