| NPI | 1154934610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202214123) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25160) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |