| NPI | 1053939413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202218761) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 21399) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |