| NPI | 1598262248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 200702332) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2007023332) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |