| NPI | 1437408176 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-117752) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 056859) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2024-09-30 |