| NPI | 1629693809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 19870) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 14310) |
| 183500000X Pharmacist (Licence: IL 051290343) | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |