| NPI | 1356855621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-15767) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 15044) |
| 183500000X Pharmacist (Licence: MO 2015042262) | |
| 183500000X Pharmacist (Licence: OK 16586) | |
| Enumeration Date | 2017-11-25 |
| Last Update Date | 2017-11-25 |