| NPI | 1033723861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST-023449) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 66954) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-09-28 |