| NPI | 1568114668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447202) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20959) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |