| NPI | 1063008092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 17904) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH24247) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2020-12-14 |