| NPI | 1457906968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 21028) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 023093) |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |