| NPI | 1851718449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 116447) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 12584-40) |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2014-03-21 |