| NPI | 1508404948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS53601) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 49153) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |