| NPI | 1962863290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-16917) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2015026760) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |