| NPI | 1376052779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 23509) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S022825) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2021-09-02 |