| NPI | 1366101990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 31268) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 43390) |
| 183500000X Pharmacist (Licence: MS T-100179) | |
| 183500000X Pharmacist (Licence: LA PST.024064) | |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2021-12-10 |