| NPI | 1144686932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2018015649) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 021324) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2021-08-16 |