| NPI | 1700228111 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-16075) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 6094) |
| 183500000X Pharmacist (Licence: MO 2013026232) | |
| 183500000X Pharmacist (Licence: KS 1-17065) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2023-11-17 |