| NPI | 1326636739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9148) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0018204) |
| Enumeration Date | 2021-01-02 |
| Last Update Date | 2021-01-02 |