| NPI | 1629430301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 2181) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 15593) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |