| NPI | 1396269924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH239180) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0014117) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2020-08-13 |