| NPI | 1518513225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 23119) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0022095) |
| Enumeration Date | 2019-08-18 |
| Last Update Date | 2019-08-18 |