| NPI | 1134730146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS62410) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 82538) |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2021-12-29 |