| NPI | 1871030379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 115296) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 17029) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |