| NPI | 1154901643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-100021) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.023750) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-04-09 |