| NPI | 1245624899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-16821) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: KS 3-06275) |
| 183700000X Pharmacy Technician (Licence: MO 2011023368) | |
| Enumeration Date | 2015-03-21 |
| Last Update Date | 2015-06-30 |