| NPI | 1629515747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12219) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 8125) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |