| NPI | 1982048195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 113840) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2006011637) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2013-04-18 |