| NPI | 1619935657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-10797) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: KS 1-10797) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |