| NPI | 1124622378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 8393189-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 8393189-8911) |
| Enumeration Date | 2020-11-29 |
| Last Update Date | 2020-11-29 |