| NPI | 1194250688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12971) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: KS 1-12971) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: KS 1-12971) | |
| Enumeration Date | 2017-04-22 |
| Last Update Date | 2017-04-22 |