| NPI | 1629655949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 37529) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 031176) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-24 |