| NPI | 1649873555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004681) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS53057) |
| 183500000X Pharmacist (Licence: VA 0202211336) | |
| 183500000X Pharmacist (Licence: MD 20638) | |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2020-12-29 |