| NPI | 1972190874 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-14040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2006013291) |
| Enumeration Date | 2020-12-26 |
| Last Update Date | 2020-12-26 |