| NPI | 1144606575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302042709) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S021449) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2021-07-16 |