| NPI | 1588059604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0023748) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2014029418) |
| 183500000X Pharmacist (Licence: TN 48415) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2024-11-12 |