| NPI | 1962718221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 18954) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0004048) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2010-08-25 |