| NPI | 1043094469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0024453) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH240432) |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2023-08-24 |