| NPI | 1164182804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP456411) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302414005) |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2021-12-22 |