| NPI | 1992219760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 16916) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 56692) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |