| NPI | 1023667771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-63309) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p8444) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |