| NPI | 1679983936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302410693) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS58363) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-07-06 |