| NPI | 1033720875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA P-MA-CV19-718684) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 79987) |
| 183500000X Pharmacist (Licence: TX 59686) | |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |