| NPI | 1770817595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 8893) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 9041) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2009-09-25 |