| NPI | 1548873649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 11072149) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA P-LA-CV19-796205) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |