| NPI | 1972090736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 15170) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2011019644) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |