| NPI | 1548667389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 116758) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 14636) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |