| NPI | 1629575196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 39846) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH028988) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |