| NPI | 1124639778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-106241) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2018032016) |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2023-02-16 |