| NPI | 1770895146 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-14841) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21157) |
| 183500000X Pharmacist (Licence: MO 2013010037) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2019-05-20 |