| NPI | 1568078046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P8960) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S024102) |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2020-09-19 |