| NPI | 1588262307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 018881) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 13455) |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |