| NPI | 1427682335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302040172) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 64346) |
| Enumeration Date | 2020-02-29 |
| Last Update Date | 2020-02-29 |