| NPI | 1609461151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-15434) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2012029732) |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2021-03-06 |