| NPI | 1134753544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 38057) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 29204) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2021-07-23 |