| NPI | 1154918829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0023442) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S025006) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2021-03-29 |