| NPI | 1659775328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 15531) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 15161) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |