| NPI | 1326628835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PH236708) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PCT.0013915) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-04-09 |