| NPI | 1376996066 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12812) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 14082) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |