| NPI | 1356951222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0024216) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH032145) |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2024-07-11 |