| NPI | 1386236222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2013005453) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 10995) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-22 |