| NPI | 1861552838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14784-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 115468-3) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |