| NPI | 1013443209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH236331) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0013558) |
| Enumeration Date | 2017-05-07 |
| Last Update Date | 2017-05-07 |