| NPI | 1376165704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0014491) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH238862) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |