| NPI | 1073896627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12395) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 9490) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |