| NPI | 1477020691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202206555) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP045163L) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |