| NPI | 1518566066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302037506) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 23978) |
| Enumeration Date | 2020-10-25 |
| Last Update Date | 2020-10-25 |