| NPI | 1598260069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2017027988) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-103765) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-03-27 |