| NPI | 1205430873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2005017353) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR P09665) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2020-11-24 |