| NPI | 1396140786 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S020979) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 18878) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2015-06-17 |