| NPI | 1194292003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 28310) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS58473) |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |