| NPI | 1417565490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS35531) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302030958) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |