| NPI | 1386252229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 29186) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202218236) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |