| NPI | 1033738257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 21818) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 16013-040) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |