| NPI | 1578949947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-106314) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 16164) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2022-10-19 |