| NPI | 1699182485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-12527) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 044508) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |