| NPI | 1043810088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 25126) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202216392) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |