| NPI | 1093309734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2014024149) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 15965) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2021-02-23 |