| NPI | 1518196963 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-15211) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS38850) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2018-04-29 |