| NPI | 1679173991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD11936) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 56119) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |