| NPI | 1679184352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 023778) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR pn06516) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2021-03-16 |