| NPI | 1568074995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS50300) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 20513) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |