| NPI | 1922377001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14132) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 293228) |
| 183500000X Pharmacist (Licence: MI 5302039363) | |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2011-12-20 |