| NPI | 1164026340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps60170) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp453033) |
| Enumeration Date | 2020-11-28 |
| Last Update Date | 2020-11-28 |