| NPI | 1457909145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-100076) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2016027159) |
| 183500000X Pharmacist (Licence: CO PHA.0022656) | |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |