| NPI | 1336774082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 122044) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 19226) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |