| NPI | 1659954204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 16064) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 009386) |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2021-05-02 |