| NPI | 1124615422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH032628) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS61841) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2020-12-22 |