| NPI | 1568951127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-16607) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 014634) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-05-08 |