| NPI | 1326329574 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13864) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 13530) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |