| NPI | 1992078786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2001025348) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-13292) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |