| NPI | 1497104038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0021631) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 69269) |
| Enumeration Date | 2016-06-04 |
| Last Update Date | 2024-06-03 |