| NPI | 1770293615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13398) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2000163529) |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-01 |