| NPI | 1992199400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-16664) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD12837) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |