| NPI | 1578174504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 19678) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS55946) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-14 |