| NPI | 1356681712 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 18337) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S019630) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |