| NPI | 1316601792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0023111) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR46864) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-12-14 |