| NPI | 1558918649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH022984) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.003236) |
| 183500000X Pharmacist (Licence: FL PS57751) | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |