| NPI | 1588332555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP451133) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 24506) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2022-02-24 |