| NPI | 1649748690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.022732) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-106267) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2022-09-19 |