| NPI | 1306339569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0021060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302039910) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |