| NPI | 1255305298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12170) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 18569) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-07-21 |