| NPI | 1124495411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 16090) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-16969) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2015-08-21 |