| NPI | 1174159230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 122477) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 18271) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-03-19 |