| NPI | 1972684041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 1561) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2004002641) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-02-03 |