| NPI | 1083809818 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13741) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 045304) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-14 |