| NPI | 1407314636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9380) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID E45234) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2022-09-14 |