| NPI | 1407584253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 18656) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P8210) |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2022-08-10 |