| NPI | 1609221274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202216002) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 24693) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2020-11-17 |