| NPI | 1497309579 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-62611) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P8381) |
| Enumeration Date | 2019-07-28 |
| Last Update Date | 2019-07-28 |