| NPI | 1245578327 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-09875) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 029842) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2013-01-23 |