| NPI | 1356966378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302046320) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 19565-40) |
| 183500000X Pharmacist (Licence: KY 020621) | |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |